A focus on the “endgame” of weight loss can be discouraging as you embark upon a health journey.  The reality is that becoming healthier is a work in progress.  Although a body weight gohal can serve as a long-run goal, health gains can be realized even in early weight loss.  As little as 3-5% of weight loss (e.g. 5-15 lbs) can produce sustained health benefits, including an improvement in glucose control and insulin functioning, a reduction in blood pressure and diastolic dysfunction and a reduction in severity of sleep apnea. 

As one loses weight, there is a gradual, whittling away of the forces that are exerted on the heart and the rest of the body by obesity.  For instance, a weight loss of approximately 15 pounds leads to a reduction of systolic and diastolic blood pressures by 8.5mm Hg and 6.5 mm Hg.  In another study, with the same average weight loss, there was also reduced peripheral resistance and increased cardiac output.  There were also improvements in glucose levels (fasting (5% reduction) and after meals (10% reduction) as well as reduction of insulin levels (approximately a 15% reduction).  A weight loss of approximately 10 kilograms would amount to a significant reduction in severity of obstructive sleep apnea, as measured by Apnea hypopnea index by 11 events per hour.    

Sustained behavior change places priority on the moment-to-moment behavior over the long-term goal.  A person who focuses on the choices that he/she faces in the day will gradually bolster the new behavior when the days become weeks and the weeks become months.  The day to day activities involve not only healthy eating but managing overall stress levels, nurturing mindfulness and avoiding any triggers to stress-eating and other unhealthy eating patterns.

While some diets boast short-term weight loss goals, the most sustainable diet relies on a gradual strengthening of one’s consistency in healthy eating in order to reinforce new, healthier patterns.  As one pursues this direction, the body will not stop at a 5 to 15 pound short-term weight loss goal but will continue to shed weight until it reaches a new steady state at or near one’s ideal weight.

Momentum builds as one begins to feel feedback from their body or receive it from others.  One might notice less knee pain or find bending down to put on socks easier.  S/he may wake up more restored from the night with greater energy during the day.  One develops a greater self-esteem and efficacy as they continue to see the results of strengthening discipline fortified by a collection of moments when healthy eating was chosen. 

The role of exercise in weight loss, I would suggest, is more for stress reduction and coping.  While not required to achieve weight loss, it is a part of optimal fitness.  The body starts to thrive activity as one loses weight.    What once may have been nearly a work-out just walking from the bed to the bathroom or from the car to the store becomes more manageable, so increased activity follows.  In stride, the person may develop a new routine such as walking or other physical activity for daily stress management and conditioning. 

In the beginning of an exercise regimen, it is more important to focus on consistency rather than on the amount of time or level of difficulty.  Walking may be sufficient to avoid injury or strain and begin in the direction on physical conditioning.  There are often chronic tendonitis issues of the feet, knees, hips and back in someone who is obese.  It is crucial to avoid overworking the body and aim for consistency and an activity as tolerated.  An injury could set a person back enough to make it possible to lose their efficacy and go back to prior unhealthy behaviors.